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Title : Screening can prevent the spread of prostate cancer to other body parts
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Screening can prevent the spread of prostate cancer to other body parts

June 17, 2016: detection of prostate cancer prostate specific antigen (PSA) has been shown to reduce mortality and the spread of prostate cancer to other parts of the body, but the PSA test remains controversial, and often leads to over diagnosis and treatment men who can not be at risk. smarter detection strategies that can improve the accuracy of diagnosis of lethal prostate cancer are urgently needed.

Through a prospective study of men in the United States, researchers at Brigham and Women's and Harvard TH Chan School of Public Health have found that measuring PSA levels in younger men (between the ages of 40 and 59 years) could accurately predict the future risk of lethal prostate cancer later in life. Their findings suggest that screening PSA levels in men in middle age may help identify those at higher risk and should be monitored more closely.

"We found a single measurement of baseline PSA level during middle age could accurately predict the future risk of lethal prostate cancer," lead co-author of Mark Preston, MD, MPH, said one physician in the Division of Urology at BWH. "These data identify subgroups of men, depending on their PSA levels of a certain age, who could benefit from screening intervals to measure the real magnitude of risk."

The current study leverages data Study Physicians Health (PHS), a randomized placebo-controlled study that tested aspirin and risk of cardiovascular events. The PHS began in 1982 and US male doctors who took part in it provided blood samples before the trial began.

These blood samples, and detailed questionnaires completed by participants in the study over the next 30 years, researchers got the information they needed to carry out the current research project. Using information from 234 men who were diagnosed with prostate cancer, including 60 who developed lethal prostate cancer and 711 controls, all between 40 and 59 years old at the start of the trial, the research team measured levels of PSA from stored plasma samples and the results followed men over time.

The researchers found that this, the level of baseline PSA single measure in midlife could accurately predict future risk of prostate cancer: In the event of lethal prostate cancer, 82 percent, 71 percent and 86 percent occurred in men with a baseline PSA above the median ages of 40-49, 50-54 and 55-59, respectively.

The study also found that men who had a PSA below the median (<1.0 ng / ml) at 60 was unlikely to develop lethal prostate cancer in the future.

"These data reinforce the hypothesis that the detection of risk stratified based PSA Midlife prostate cancer should be considered in men aged 45 to 59 years," said senior author Lorelei Mucci, ScD, associate professor of epidemiology in the Department of epidemiology at Harvard TH Chan School of Public Health.

"Our study does not imply an immediate prostate biopsy or definitive treatment in younger men with higher PSA levels at baseline, as this could lead to over-diagnosis is required. rather, these men should undergo PSA testing more intensively to allow early identification of cancer and potential cure while it is still possible. "

the authors note that the study's limitations include the population of study it consists primarily of caucasian men, including limited lethal opportunistic screening events and an unknown proportion of participants may have suffered before the study.

Source: HSPH

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